Postpartum – Get Back in the Game!

Having a baby has a few perks. One of them is a temporary (or quite long) break from menstruation. It's very carefree when tampons are just cargo for your child's toy truck. When is such a break normal and healthy, and when should it be a cause for concern?

Pregnancy – what next?

After 9 months of freedom from menstruation, it is time to give birth to a child. After giving birth – both by cesarean section and after natural birth – comes the postpartum period. I have already written about the postpartum period here , so now I will only briefly introduce the subject. The postpartum period is the period of regeneration after childbirth and the removal of so-called postpartum waste (blood and tissue that lined the uterus during pregnancy) from the body .

Postpartum discharge can be very heavy at first, but the bleeding should lessen over time. The postpartum period can be different for each person, both in terms of the amount of postpartum discharge and the time after which any spotting stops. Discharge occurs for up to 6 weeks (normal), in my case it was 2 weeks. This is usually a few weeks of bleeding onto a pad (no tampons or menstrual cups allowed due to the increased risk of infection when the uterine opening is not yet completely closed). It's a bit like Mother Nature trying to "make up" for all that amenorrheic pregnancy.

After the 6 weeks, a gynecological check-up is recommended to assess the person's condition and healed wounds, if any (for example after an episiotomy or cesarean section).

After giving birth…

You won't guess what. The big unknown. Postpartum periods come at different times for each person. When you get your first period after giving birth depends on many factors - for example, whether you decide to breastfeed . If you are formula feeding, your first period after giving birth should come within 6 to 8 weeks. If you are breastfeeding, you should do it on demand - your baby decides how much and when to eat (usually 8 to 10 times a day). Exclusively breastfed babies do not drink any liquids (not even water!) or solid foods other than breast milk. In this case, don't expect your period to come quickly after giving birth (although this is not a rule).

Why don't people who breastfeed get their periods as soon as possible?

Usually, people who breastfeed do not have periods too soon because of hormones. High levels of prolactin (a hormone needed to produce breast milk) inhibit the ovaries (estrogen production). As a result,ovulation does not occur (so-called lactation infertility), no egg is released, and the lining of the uterus (endometrium) remains thin, so there is no material to expel. In a normal cycle, it is the endometrium that grows and if the egg is not fertilised, it is excreted from the body as menstruation.

That's exactly what happened to me. Pregnancy, delivery, breastfeeding for 1 year and 4 months, then pregnancy (hello, hello, where's the first period after delivery?), birth of the second child and breastfeeding, which is still ongoing. And I'm waiting to try the Your KAYA menstrual cup, because I haven't had the chance yet! As you can see, the first period after delivery is always an individual matter for each person. Before the bleeding returns, you can get pregnant again (more on that later).

Menstruation during the puerperium

Of course, it also happens (very rarely, but it does happen) that a person is breastfeeding and still has periods during the postpartum period. However, the appearance of a period up to the 6th week after delivery is unusual (this refers to a situation in which the postpartum feces are already trace or disappear, and bleeding suddenly appears). Any major bleeding, when the feces were already smaller, requires consultation with the attending physician. It may turn out that it is not a period after all, but atypical bleeding (for example, cleansing the uterus of debris after childbirth), requiring additional and urgent actions. The doctor will perform an ultrasound and assess whether your bleeding is a period or not - the decision regarding treatment is up to the doctor.

Menstruation and breastfeeding

Menstruation during breastfeeding usually occurs irregularly (it may also be less abundant), and stabilizes only after the child is weaned (i.e., breastfeeding is stopped). This irregularity should not cause concern.

Importantly, menstruation does not interfere with breastfeeding – it does not change the taste of the milk or its value. The child may eat less than usual during this time or – on the contrary – eat more often if milk production decreases at this time (yes, this can happen and it is normal).

How long after discontinuing treatment does menstruation return?

Menstrual bleeding usually returns 4 to 6 weeks after stopping breastfeeding.

The first period after childbirth – is anything known for sure?

Of course! It can be different, of course – both in terms of when the first period will appear after giving birth, and what that (or each subsequent) period will look like.

However, what is known for sure and what is very important: you can ovulate before your period comes, so returning tocontraception only after your first period after giving birth is NOT a good idea. Although breastfeeding reduces fertility, it does not provide an absolute guarantee that you will not get pregnant again. Ask your doctor about contraception that is safe while breastfeeding. In addition to condoms, there are single-ingredient hormonal contraceptives that can be taken during lactation.

I want my period back!

I have already mentioned that your period after giving birth can be completely different from the one you had before pregnancy. This is because your body is adjusting to menstruation all over again. Periods that were once heavy can become scanty (and vice versa), and they can also get shorter or longer. They can be irregular at first. Your first periods can be more or less painful. In this regard, most changes are normal – which doesn’t change the fact that it’s worth mentioning this to your doctor during a routine visit.

However, regardless of what your first period after giving birth is like, you can use any hygiene products (including tampons or a menstrual cup), as long as the postpartum period has ended.

The first period after childbirth and the return to the menstrual cycle is just one part of returning to health and to the state before pregnancy. Everything takes time, because at that time everything is turned upside down for a moment. The most important thing is to observe your own body and react quickly to disturbing symptoms. Remember to report all of them during the medical consultation.

Do Your Periods Change After Pregnancy? , health.clevelandclinic.org/2017/04/will-your-periods-change-after-pregnancy [accessed on 04/08/2021].
Exclusive breastfeeding for optimal growth, development and health of infants , who.int/elena/titles/exclusive_breastfeeding/en/ [accessed on 04/08/2021].
Menstrual cycle: What's normal, what's not , mayoclinic.org/healthy-lifestyle/womens-health/in-depth/menstrual-cycle/art-20047186?pg=2 [accessed on 04/08/2021].